<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <title>电子合同申请</title>

    <!--引入本地 element-ui 的样式，-->
    <link rel="stylesheet" href="/admin/plugin/element-ui/index.css">
    <script type="text/javascript" src="/admin/js-css/js/vue.min.js"></script>
    <script type="text/javascript" src="/admin/plugin/element-ui/index.js"></script>

    <!--    引入Layui组件-->
    <link rel="stylesheet" href="/admin/plugin/layui/dist/css/layui.css" tppabs="http://res.layui.com/layui/dist/css/layui.css"  media="all">
    <script src="/admin/plugin/layui/dist/layui.js" charset="utf-8"></script>

    <script type="text/javascript" src="/admin/js-css/js/jquery-1.7.2.min.js"></script>
    <script type="text/javascript" src="/admin/js-css/js/mx1.0.js?v=1.1.1"></script>
    <script type="text/javascript" src="/admin/html/module/yumenyoutian/js/api.js"></script>

    <style>
        .lang_line {
            border-top: 1px solid #ccc;
            padding-top: 5px;
        }

        .changeLHight .el-form-item__label{
            line-height: 16px !important;
        }

        body{
            padding: 20px;
        }

    </style>

</head>
<body>

    <div id="app">
        <el-form
                ref="formData"
                inline
                size="mini"
                :model="formData"
                label-width="110px"
                status-icon
                class="help"
        >
            <helpBtn :helpId="1013" />
            <el-form-item label="序号" prop="aic001" >
                <el-input v-model="formData.aic001" disabled></el-input>
            </el-form-item>
            <el-form-item label="个人编号" prop="aac001" >
                <el-input v-model="formData.aac001" disabled></el-input>
            </el-form-item>
            <el-form-item label="直系亲属编号" prop="pcc001" >
                <el-input v-model="formData.pcc001" disabled></el-input>
            </el-form-item>
            <el-form-item label="公民身份证号码" prop="aac002" >
                <el-input v-model="formData.aac002" disabled></el-input>
            </el-form-item>
            <el-form-item label="单位名称" prop="aab001" >
                <el-input v-model="formData.aab001" disabled></el-input>
            </el-form-item>
            <el-form-item label="年度" prop="aae001" >
                <el-input v-model="formData.aae001" disabled></el-input>
            </el-form-item>
            <el-form-item label="姓名" prop="aac003" >
                <el-input v-model="formData.aac003" disabled></el-input>
            </el-form-item>
            <el-form-item label="所属期" prop="aae002" >
                <el-input v-model="formData.aae002" disabled></el-input>
            </el-form-item>
            <div class="lang_line"></div>
            <el-form-item label="医疗机构" prop="kna002">
                <el-input v-model="formData.kna002"></el-input>
            </el-form-item>
            <el-form-item label="疾病名称" prop="kna001">
                <el-input v-model="formData.kna001"></el-input>
            </el-form-item>
            <div class="lang_line"></div>
            <el-form-item label="医疗费用总计" prop="kna003">
                <el-input type="number" min="0" v-model="formData.kna003"></el-input>
            </el-form-item>
            <el-form-item label="油田外报销金额" prop="kna004">
                <el-input type="number" min="0" v-model="formData.kna004"></el-input>
            </el-form-item>
            <el-form-item label="补充医疗报销金额" class="changeLHight" prop="kna005">
                <el-input type="number" min="0" v-model="formData.kna005"></el-input>
            </el-form-item>
            <el-form-item label="个人自费金额" prop="kna006">
                <el-input type="number" min="0" v-model="formData.kna006"></el-input>
            </el-form-item>
            <el-form-item label="其他金额" prop="kna007">
                <el-input type="number" min="0" v-model="formData.kna007"></el-input>
            </el-form-item>
            <div class="lang_line"></div>
            <el-form-item label="普通门诊总费用" prop="kna008">
                <el-input type="number" min="0" v-model="formData.kna008"></el-input>
            </el-form-item>
            <el-form-item label="普通门诊油田外报销金额" class="changeLHight" prop="kna009">
                <el-input type="number" min="0" v-model="formData.kna009"></el-input>
            </el-form-item>
            <el-form-item label="普通门诊报销金额" class="changeLHight" prop="kna010">
                <el-input type="number" min="0" v-model="formData.kna010"></el-input>
            </el-form-item>
            <el-form-item label="普通门诊自费" prop="kna011">
                <el-input type="number" min="0" v-model="formData.kna011"></el-input>
            </el-form-item>
            <el-form-item label="普通门诊其他" prop="kna012">
                <el-input type="number" min="0" v-model="formData.kna012"></el-input>
            </el-form-item>
            <div class="lang_line"></div>
            <el-form-item label="特慢病总费用" prop="kna013">
                <el-input type="number" min="0" v-model="formData.kna013"></el-input>
            </el-form-item>
            <el-form-item label="特慢病油田外报销金额" class="changeLHight" prop="kna014">
                <el-input type="number" min="0" v-model="formData.kna014"></el-input>
            </el-form-item>
            <el-form-item label="特慢病补充报销金额" class="changeLHight" prop="kna015">
                <el-input type="number" min="0" v-model="formData.kna015"></el-input>
            </el-form-item>
            <el-form-item label="特慢病个人自费金额" class="changeLHight" prop="kna016">
                <el-input type="number" min="0" v-model="formData.kna016"></el-input>
            </el-form-item>
            <el-form-item label="特慢病其他金额" prop="kna017">
                <el-input type="number" min="0" v-model="formData.kna017"></el-input>
            </el-form-item>
            <div class="lang_line"></div>
            <el-form-item label="住院总金额" prop="kna018">
                <el-input type="number" min="0" v-model="formData.kna018"></el-input>
            </el-form-item>
            <el-form-item label="住院油田外报销金额" class="changeLHight" prop="kna019">
                <el-input type="number" min="0" v-model="formData.kna019"></el-input>
            </el-form-item>
            <el-form-item label="住院补充报销金额" class="changeLHight" prop="kna020">
                <el-input type="number" min="0" v-model="formData.kna020"></el-input>
            </el-form-item>
            <el-form-item label="住院个人自费部分金额" class="changeLHight" prop="kna021">
                <el-input type="number" min="0" v-model="formData.kna021"></el-input>
            </el-form-item>
            <el-form-item label="住院其他金额" prop="kna022">
                <el-input type="number" min="0" v-model="formData.kna022"></el-input>
            </el-form-item>
        </el-form>
    </div>

    <script>

        var vm = new Vue({
           el:"#app",
            data() {
                return {
                    formData: {
                        kna002: "",
                        kna001: "",
                        kna003: "",
                        kna004: "",
                        kna005: "",
                        kna006: "",
                        kna007: "",
                        kna008: "",
                        kna009: "",
                        kna010: "",
                        kna011: "",
                        kna012: "",
                        kna013: "",
                        kna014: "",
                        kna015: "",
                        kna016: "",
                        kna017: "",
                        kna018: "",
                        kna019: "",
                        kna020: "",
                        kna021: "",
                        kna022: "",
                    },
                };
            },
            created() {
            },
            methods: {
                // 提交表单保存数据
                async submintForm() {
                    load();
                    const res = await api.postBody(
                        "/admin/api/cfrc/CertificateController/save",
                        this.formData
                    );
                    layer.closeAll();
                    if (res.code == 1) {
                        console.log(res);
                        top.alert(res.msg);
                    } else {
                        top.alert(res.msg);
                    }
                },
                // 根据选择信息获取表单数据-职工或家属
                async getFormData(formData) {
                    // 将父组件请求到的数据渲染至子组件
                    this.formData = formData;
                },
                // 关闭窗口
                handleClose() {
                    // this.$refs['formData'].resetFields()
                    this.remoteClose();
                },
            },
        });

        function setData(data){
            vm.formData = data;
        }
    </script>
</body>
</html>